This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, October 29, 2012

Weekly Australian Health IT Links – 29th October, 2012.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Quite a busy week with the Health Minister out talking up the PCEHR and then offering a trivial sum to have some clinicians talk it up while thinking that GPs are all going to be able to turn ona technological dime and make it all work - supported by vendors who are still not entirely clear about how it will all hung together and how much disruption lies ahead.

The remarks made at Senate Estimates last week have finally been noticed and we have seen a lot of reporting - even internationally - on the cancellation of an IBM contract. Speculation that this will wind up in the courts is rife - but I suspect it will be sorted long before it gets to that. No one wins when the lawyers get involved!

Of course Windows 8 also hit the shelves this week. It is certainly a bit different so it will be interesting to see how it plays out in terms of adoption over time.

It was good to see that all was well logging in to the NEHRS today. That’s twice in a row it has worked. The odd thing is that the Australia.gov.au login screen looks quite distorted - no idea why but has been the same for a couple of week. Go figure (using Firefox as browser).

This is a useful link if you want to keep an idea on outages and so on.

Quote of the week from DoHA on the messed up graphic which had ovaries as kidneys etc:

“During a Senate estimates hearing on Friday, health department Assistant Secretary Adam Davey said the error occurred after the poster was sent back to the graphic designer with amendments and an old file version was accidentally used.

"The department does have processes in place to ensure the accuracy of our communications. On this occasion they were not followed," Mr Davey said.”

AN ePIP software update that crippled some practices using the most popular practice software has sparked concerns about looming disruption from the upcoming e-health record rollout.

Some practices using Medical Director were forced to return to paper records and cut consult times after the software’s latest update drastically slowed their IT systems.

Medical Director owner Health Communication Network (HCN), a Primary Health Care subsidiary, confirmed it issued a new version of the program, aimed at ensuring practices would qualify for the e-health Practice Incentives Program payment (ePIP), to its 17,000 users in September, with a follow-up patch to fix bugs earlier this month.

Josh Gordon

THE Baillieu government has not signed up to a new national ''real time'' prescription tracking system to prevent the growing abuse of painkillers, warning it is not a ''magic bullet''.

With mounting concern about the misuse of drugs such as fentanyl and oxycodone, the Royal Australian College of General Practitioners and the federal government are pushing for a nationwide electronic system that would allow pharmacists, doctors and state health authorities to monitor the prescribing and dispensing of addictive drugs.

The plan, which is being funded by the federal government and trialled in Tasmania, would allow health authorities and professionals to check up on people suspected of ''doctor-shopping'', forging prescriptions and trafficking painkillers using a national database.

Access to the latest skills and research on acute and chronic pain management will be provided to GPs through an Australian-first online learning tool launched at the GP12 conference yesterday.

The innovative Active Learning Module (ALM) pain management program developed by the Faculty of Pain Medicine (FPM) of the Australian and New Zealand College of Anaesthetists (ANZCA), the RACGP, and the Bupa Health Foundation will give primary healthcare professionals immediate access to the latest evidence-based research and skills to help prevent transition from acute to chronic pain and improve their patients’ quality of life.

General practitioners will play a vital role in the establishment of Australia's e-health system, according to federal Health Minister Tanya Plibersek.

Speaking at the opening of the Royal Australian College of General Practitioners (RACGP) annual conference on the Gold Coast, Ms Plibersek said the government was investing $2.55 million to develop training programs aimed at GPs.

The minister said the RACGP, in consultation with the Australian College of Rural and Remote Medicine, will use the funds to develop an e-health syllabus and education modules.

Opening the GP12 conference on the Gold Coast, Ms Plibersek said the Health Performance Authority was working with the Australian Bureau of Statistics to find ways to compare geographically and socially similar regions.

This would identify regions with high rates of potentially avoidable admissions or prolonged hospital stays, and highlight “how to best reduce any unwarranted variation,” Ms Plibersek said.

GPs will have access to peer support and online education tools under a new ehealth plan announced today by federal health minister Tanya Plibersek.

Under the $2.55 million funding agreement, The Royal Australian College of General Practitioners (RACGP) will train a cohort of 30 “GP advocates” to deliver peer-to-peer ehealth support and education via a seminar program delivered at up to 200 sites around Australia.

Human Services steps in as provider.

The National E-Health Transition Authority (NEHTA) has sacked IBM as provider of the National Authentication Service for Health (NASH) after it failed to deliver the service on time.

The NASH service designed and built by IBM was intended to provide a secure means for clinicians to connect with the Federal Government’s $467 million Personally Controlled Electronic Healthcare Record (PCEHR) system.

IBM won the $23.6 million NASH contract in March 2011 and was due to deliver the system on 26 June 2012.

news The National E-Health Transition Authority and IBM this afternoon confirmed Big Blue’s $23.6 million contract to build a key component of the Federal Government’s Personally Controlled Electronic Health Record project had been “terminated”, just 18 months after the contract was initially inked. However, it is unclear where culpability lies in the situation.

As part of a $466.7 million investment in the e-health records announced in September 2010 by the Federal Government, the nation’s peak e-health body NEHTA chose IBM in March 2011 to build and manage its new National Authentication Service for Health (NASH) system, which aims at establishing a nationwide secure and authenticated service for both healthcare organisations and personnel that have to exchange e-health information.

At the time, NEHTA chief executive Peter Fleming said NASH would improve healthcare for both professionals and patients. “Our agreement with IBM enables NEHTA to build a system that will give healthcare professionals timely and secure access to appropriate patient information,” he said in a statement. “In turn, the NASH program will take us one step closer to broader healthcare access for all Australians.”

The Australian federal government has terminated a contract with IBM to build the National Authentication Service for Health (NASH), a key security component for the country's national health IT system.

The Australian National E-Health Transition Authority (NEHTA) has terminated the $23 million contract with IBM, citing missed deadlines and delays.

IBM's AU$23.6 million contract with the National E-Health Transition Authority (NEHTA) is in tatters, and both sides have brought the lawyers in as the government implements an interim National Authentication Service for Health (NASH) system.

The deal was first signed in 2011 for delivery by June 30, 2012. IBM was tasked to develop a system that would use public key infrastructure and secure tokens, such as smart cards, in order to provide an authenticated service. This is so that healthcare personnel and providers can exchange e-health information, including referrals, prescriptions, and personally controlled electronic health records (PCEHRs).

GP telehealth rebates will be restricted to people in designated areas of need and after hours video conferencing restricted to people in aged care facilities as the federal government clings to its forecast budget surplus.

The private health insurance rebate, which was already means tested in the last budget, will now be reduced, Treasurer Wayne Swan said today as he blamed global economic conditions for across the board spending cuts in his Mid-Year Economic and Fiscal Outlook (MYEFO) statement.

SA Health is establishing a body to oversee its $485 million investment into statewide ehealth transformation.

According to government documents released this week, the new eHealth Program Management Office’s (ePMO) primary role will be ensuring successful delivery of the $408 million Enterprise Patient Administration System (EPAS) and the associated statewide e-pathology ($30.4 million), imaging ($22 million) and financial and supply chain systems ($25 million).

THE Department of Health and Ageing has refused to release details of a crucial risk-assessment study conducted by Ernst & Young on the personally controlled e-health record system.

The department's e-health division head, Matthew Corkhill, ruled that it was against the public interest to release the 21-page report, Assessment of PCEHR Information Security Threat and Risk Assessments, in response to a Freedom of Information request lodged by The Australian in July.

THE Department of Health and Ageing has refused to guarantee that its much vaunted e-health record system is risk-free after more than 140 risks were identified before it went live on July 1.

The Gillard government's personally controlled e-health record system, developed by Accenture, contained a staggering 142 risks of which 32 were rated extreme, 77 high and 33 medium.

The detailed risk assessment study, obtained by The Australian, was prepared by the National E-Health Transition Authority (Nehta) and submitted to the Health Department and other relevant parties about two months before the July go-live date.

news Global technology giant IBM has written to the new LNP Queensland Government claiming it “successfully delivered” against milestones agreed with the previous Labor administration with respect to the disastrous payroll systems overhaul at Queensland Health, which has already cost the state $417 million and will need another $837 million to fix over the next five years.

The project was first kicked off in late 2007, when Queensland Health determined there was a need to look at a new payroll platform to replace the previous platform, based on Lattice and ESP software, which had been progressively implemented from 1996. Partially as a result of the fact that the state had decided to standardise on SAP’s ECC5 and Infor’s Workbrain software across its whole of government operations, those same platforms were picked for the Queensland Health implementation.

A question arose in the PCEHR program: is the date 00010101 a valid date in CDA, and if not, what is the valid date range allowed?

Well, firstly, as far as the TS data type is concerned, 00010101 is a valid date – the 1/1/01, the nominal year of Jesus’ birth (only he wasn’t born that year). But just because it’s legal according to the type doesn’t mean that it makes sense – especially as the date of onset of a patient’s problem. This caused some discussion about what dates the national program should accept for clinical dates – what should be valid? When I looked around, I discovered remarkably little good information about the general subject of what dates are reasonable to accept in clinical records.

The iBGStar Diabetes Manager helps monitor blood glucose levels for those with Type 1 or 2 diabetes. A small accessory for taking blood samples clips to your iPhone (the iPhone 5 isn't supported), alerting you when your blood sugar is out of range.

THE state-owned centre for information technology excellence in Victoria was undermined by corrupt behaviour, botched procurement systems and sham contracting, the acting Ombudsman has found.

Acting Victorian Ombudsman John Taylor said CenITex breached procurement policies and guidelines and accused it of nepotism and favouritism. He found some appointments were made on the basis of fabricated or false documentation and staff deeply compromised by conflicts of interest. "Serious improper conduct did occur," he found.

Lance Ulanoff

Windows 8 changes the security game in ways that attempt to push aside security software giants such as Norton and Symantec.

Security, or lack thereof, has dogged Microsoft Windows since the mid 1990s. This was bad news for consumers who were fond of risky practices such as sharing 3.5-inch floppies and downloading unknown files from services like AOL, UseNet Groups and, later, the web and file-sharing services. It was a boon, though, for a legion of security software companies that all dove into the breach to protect us from a vulnerable operating system and ourselves.

ORLANDO -- Trying to stay ahead of the curve when it comes to IT issues is not a job for the faint of heart. That point was driven home at Gartner's IT annual IT Symposium fest here where analyst David Cappuccio outlined what he called "new forces that are not easily controlled by IT are pushing themselves to the forefront of IT spending."

The forces of cloud computing, social media/networking, mobility and information management are all evolving at a rapid pace. These evolutions are largely happening despite the controls that IT normally places on the use of technologies, Cappuccio stated. "IT was forced to support tablets, and end users forced them to support IM and wireless networks a few years ago. And more such technologies are on the horizon," he said.